의 유의성 있는 요인을 파악한 점에 이 연구에 의의가 있으며, 이에 본 연구 를 바탕으로 더 발전 된 연구가 이루어지기를 기대해 본다.
참고문헌
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Abstract
Association between periodontal disease and poor glycemic control
among over 65 years with insulin or oral antidiabetic agents
Jung, Ji-Hyun Graduate School of Public Health Yonsei University
(Direct by Professor Woo-Jin Chung, Ph.D)
88.5% of elderly people over 65 years old have one or more chronic diseases in korea. So consideration is needed for chronic disease management of the elderly people. Diabetes mellitus is a chronic disease that occurs frequently after hypertension and arthritis in elderly people.
Also oral diseases affecting nutrient intake and digestion should be managed as well as systemic diseases. Periodontal disease, a typical oral disease, is the 6th common complication of diabetes mellitus.
Diabetes and Periodontal disease influence each other and the prevalence of these diseases has increased as age increases. So, both
diseases must be managed together. Examination Survey(KNHANES) from 2012 to 2014. This study included adults aged≥65 years and analyzed 369 subjects with insulin or oral antidiabetic agents among a total of 23,625 interviewees participated in the health interview survey. The periodontal disease and number of periodontal disease in sextants were selected as variables of periodontal status factors. Socio-demographic factors and health behavior factors that affect poor glycemic control were selected referring to previous studies as control variables. SAS version 9.4 was used for statistical analysis and descriptive analyses, Rao-scott chi-square, and logistic regression that reflected the survey characteristics was performed carried out.
Of the 369 patients, 286 (76.7%) had HbA1c≥6.5% indicating poor glycemic control. In the Rao-scott chi-square analysis showed that there was a high rate of poor glycemic control in case of periodontal disease patient groups, patients who were number of periodontal disease in sextants=3. However, there was no statistical significance.
The results of logistic regression that reflected the survey characteristics, the odds ratio of periodontal disease to healthy
periodontal status was 2.83. The odds ratio of subjects at 'number of periodontal disease in sextants=1' and 'number of periodontal disease in sextants=3' to number of 'periodontal disease in sextants=0' was 3.06, 5.22, respectively. Other statistically significant risk factors were private insurance membership, duration of diabetes, and co-morbid disease as well as BMI, number of brushing after meals, and drinking.
This study analyzed the relationship between periodontal disease and poor glycemic control by controlling the socio-demographic factors, health behavior factors affecting poor glycemic control among over 65 years with insulin or oral antidiabetic agents. The results of this study show that periodontal disease is the factor affecting glycemic control in over 65 years with insulin or oral antidiabetic agents.
Therefore it is deemed necessary to include guidelines for the prevention and improvement of periodontal disease in program for glycemic control.
Keyword : Over 65 years, Insulin, Oral antidiabetic agents, Periodontal disease, Poor glycemic control, Korean National Health and Nutrition Examination Survey(KNHANES)